Meanwhile, students are returning to school. Parents, carers, teachers and students have many questions. Does sitting next to someone with the virus in the classroom or playing together on the playground spread monkeypox? Will it spread by sharing food or drink? Are there certain higher risk activities for K-12 students? What about college students? What about the risks of other infectious diseases?
CNN: Let’s talk about some examples of common scenarios in school settings. Can monkeypox be spread by someone sitting next to you in a classroom or taking a bus together?
arts: This is extremely unlikely. Monkeypox doesn’t spread just by sitting next to a person. Again, this is not Covid-19 – the virus is hardly contagious.
CNN: How about the kids playing together on the playground? Does touching the same objects put them at risk of monkeypox transmission?
arts: In theory, a child with an exposed rash could come into contact with another child while playing together. Small children also put things in their mouths that other children can touch, so transmission can occur.
That could change if outbreaks start to hit children, but that’s not what we’ve seen so far.
CNN: Can monkeypox spread by sharing drinks or food?
arts: Yes. Again, this is a lower risk than other intimate activities discussed earlier, such as sex, but sharing drinks or food is a possible mode of transmission. People infected with monkeypox should not share utensils or food or drink with others.
CNN: You’ve said before that it can spread through sheets and towels. Should parents and caregivers be concerned about their children trying on clothes and avoiding hotel trips?
arts: I do not think so. If someone has monkeypox, they can spread the virus to clothing and other things that come into contact with the rash — such as sheets, towels, and other bed sheets. If someone in your family has monkeypox, no one should share their clothing or bed.
But it’s a far cry from avoiding trying on clothes at the mall or staying at a hotel. Of course, it’s theoretically possible that someone who just tried on the same piece of clothing has contracted monkeypox and left the virus on the clothing, but the chances of that happening are very low. The same goes for hotels, where sheets and towels should be changed between guests anyway.
CNN: Are there certain higher-risk activities for K-12 students?
arts: Activities that involve prolonged skin-to-skin contact are at higher risk. For example, children who participated in wrestling or football were at higher risk than children who participated in trail running or swimming.
That doesn’t mean kids shouldn’t play contact sports. Also, the current incidence of monkeypox in children is so low that this should not be a major problem.
Some students in the school are sexually active. My concern is for students, especially those who have multiple partners or have sex with people they don’t know well, since monkeypox is primarily spread through this intimate activity.
CNN: It reminds me of college students. What are their high-risk activities and what precautions should they take?
arts: Let’s run the activity by risk level. The highest risk is having sex with multiple partners. Intimate activities such as kissing and hugging with multiple people are also high-risk.
Sharing of drinks, food and items such as cigarettes and e-cigarettes may also contribute to the spread of monkeypox, although this risk is lower. Monkeypox transmission has also been recorded in people who danced in close proximity to many other people, especially if most people were not wearing clothing on certain parts of their bodies – which would lead to more skin-to-skin contact.
Being a platonic roommate with someone is less risky, as is playing most sports. Other everyday activities, such as attending classes, dining with peers and socializing with friends, are extremely low risk. Teaching staff, professors, and other school and university staff are at extremely low risk if they do not have direct skin-to-skin contact with students or each other.
CNN: What precautions would you advise college students to take?
arts: Understand the highest risk activities and try to reduce the risk. Since sexual activity is the highest risk, consider reducing the number of sexual partners until you are vaccinated. Before engaging in intimate activities, ask the other person if they have a new or unexpected rash—if possible, consider exchanging contact information with any new sexual partners in case you or they develop symptoms later. Try not to share drinks, food, or cigarettes with multiple people you don’t know. If you’re going to a nightclub or bar where you expect to be in close contact with many people, consider wearing long sleeves and long pants to cover areas where you are in close contact with others.
This reminds me – students should know where to go for the test. Many universities will offer on-site testing. Others will suggest you go to a nearby commercial lab. Universities should establish quarantine procedures. It can be helpful to know what they are ahead of time so you are not caught off guard should you test positive.
CNN: The big picture – how should parents, caregivers, teachers and students think about the risk of monkeypox and the risk of other infectious diseases?